How to Tick Check Yourself

Or, Humans Get Tick-Borne Disease, too!

Did you think that because the weather is getting cooler, it’s not tick season anymore? If so, you’d be wrong. In fact, where I live, the worst times of year for ticks are the spring (usually April through June) and the fall (usually October and November). In fact, after our midsummer lull of no ticks, last night I pulled one off my shoulder.

As I’ve said before, this is also not just a Northeastern United States issue. No sooner had I posted my instructive post on how to tick-check your dog, that I stumbled across a Southern blogger who is unintentionally misinforming her readership by saying, “Good news: if you live below the Mason Dixon line there is a relatively low risk of Lyme Disease. Y’all can breathe easy.”

Oh dear. The many, many people I know with Lyme disease and other tick-borne infections who live in Florida, Virginia, North and South Carolina, and Georgia could tell her it ain’t so. (One of the foremost Lyme doctors in the world is in North Carolina, and I know a slew of Lymies in the Virginia/DC area.)

As requested by various readers and friends, here is my how-to guide on tick-checking YOURSELF! (And your kids or family members, etc.)

As I’ve said in other posts on Lyme disease, it is best to check yourself once a day, every day that the ground is not completely covered in snow — regardless of where you live.

If you are too sick to handle that, try to check yourself every day that you go outside (even if it’s just into your yard, since most cases of Lyme transmission are from ticks picked up in one’s own yard) or if you have dogs, cats, or other animals that go outside and then come back in. If you are a wheelchair user, please refer to my post on when wheelies should tick-check themselves, as it’s different than for walkies.

Checking yourself for ticks is usually easier than checking your dog. For example, you don’t have to give yourself treats to allow yourself to handle your paws hands. There’s also less fur to search through.

Ticks will attach anywhere, so it’s important to check the whole body. That said, there are some areas they seem to prefer to attach, and even more importantly, where they might go longer undetected. These are areas that provide some protection or cover because they are in skin folds or creases or under hair, including

• Between the toes
• Behind the knees
• In the groin
• In the naval (belly button)
• Under the breasts
• In the armpits
• Behind the ears
• At the nape of the neck
• On the scalp/under the hair

But, they can be anywhere. For example, the three ticks I’ve pulled off myself this year were on my scalp (the top of my head), at the nap of my neck (also scalp, because it was under my hair line), and on my inner thigh. In each case, these were dog ticks, not deer ticks, and they had been attached three hours or less.

Members of my household have found ticks on themselves or loved ones on their forearms, calves, backs, shoulders — just about anywhere. In fact, last night I found a deer tick attached to my upper arm/shoulder area. I had not been out of the house that day or the previous one, so it must have been carried in on the dog, who spends a fair amount of time in contact with me or on my bed.

In an ideal world, we’d all have a tick-checking partner to examine areas that are hard to see ourselves, and for whom we could return the favor. We’d also all be sighted, have range of motion, strength, and flexibility in our bodies and sensitivity in our hands. However, this is not always possible. So, you do the best you can.

As with dogs, it’s good to make this a habit. Setting a daily routine that follows a particular time of day or activity, and that follows a familiar path along the body can help you keep track of what’s been checked and what hasn’t. Use what works for you. I’ll give my household as an example.

Tick-Checking with Two People

We do nightly checks before bed. First, we turn on all the lights, so it’s as bright as possible. Betsy and I check the dog. She likes to check him first, in case any ticks crawl off of him and onto us. I don’t feel as strongly about it, because ticks don’t usually move very fast. It can be useful to put down a light-colored sheet while you check your furry household members, because a tick will show up more obviously there if it is crawling toward you.

Then, we do us. It’s best to get naked to tick check. You should check your clothing, inside and out, either before or after you check your body.

Because of my disabilities, we do our tick-checks on the bed. We start at the feet and work up. I extend my legs, and she looks between each toe on my right foot, then examines the top and sides of the leg. She lifts my leg in the air and examines the underside. Then, the same on the left foot and leg. Then the creases where my thighs meet my abdomen (ticks like creases and skin folds). I spread out my pubic hair so she can see under/through it, and also my labia (more skin folds). I don’t happen to know of women finding ticks on their genitals, but I know two men who have found them on their testicles, so I see no reason the same couldn’t happen with female “parts.”

Then we check my belly button, and I lift each breast, one at a time to check under there. (I have found ticks under others’ breasts before — it’s warm, moist, and hidden; ticks seem to like that.) Then my right armpit (and you should spread the hair around if you have thick hair there) and my arms, both sides. The same on my left underarm and arm.

I turn, and she looks at my back and my buttocks. We also check the external anus.

We spend probably the most time on the scalp, because hair obscures ticks, and because ticks like the scalp. If you have long hair, it’s important to lift it to check the neck, especially the nape of the neck.I lean forward with my face on a pillow. Because I have long hair now, Betsy starts on one side (checking in the ear and behind it), and sections the hair, feeling and looking all along one row, from the neck to the forehead. Then the next row, working her way like that to the other ear and side of head.

Since Betsy’s hair is very short, my job is easier. I start at the nape of her neck, pulling against the grain of the hair, using my fingertips along the scalp. I am feeling for any bumps or unusual protrusions while also looking at her scalp as the hair is moved. Checking ears, sideburns, etc., is important. I should add that although I’ve never tick-checked a man, if someone has a mustache or beard, it’s important for them to run their fingers through it and feel all their face and neck skin to make sure nothing is hiding under it.

If you are able to stand and/or sit up, you can make a lot of this go faster and easier by stripping and standing with your back to your partner. They can check your back, buttocks, anus, and backs of your legs. Then you turn, and they check the fronts and sides of your legs, abdomen, belly, genitals (if you’re male), breasts (including underneath), underarms, and all sides of your arms.

Then you can sit down to check between toes, genitals (if female), and head and scalp.

Checking Yourself, By Yourself

There are times Betsy or I have to check ourselves on our own. Here’s how we do it.

Betsy stands at a wall mirror. She checks all the parts of her body she can see herself, then turns with her back to the mirror to check her back and other areas she can’t see. Then she runs her hands over any areas she can’t see, such as back of legs and behind knees, etc. This is also how she does her hair — running her fingers over every part of her scalp.

I check myself in bed. The most important checking is tactile — I run my hands over every place I can touch on my body. When I have found ticks attached to myself, it has almost always been my fingers that discovered them before my eyes had any clue.

For any places I can’t reach well, or to double-check, I use a hand mirror — such as spreading my toes as much as I can with a mirror reflecting the bottom of my feet. This is also how I check the backs of my legs, under my breasts, and my groin and anus.

For my back, which I cannot touch all over, I use two mirrors — looking into one, with the other behind me. I use most of my energy to feel my scalp. You can think of it as a methodical scalp massage, moving your fingers all over your scalp as if you were lathering shampoo, and also feeling behind your ears.

The more you get used to feeling or seeing every mole, bump, or irregularity of your skin, the easier it will be to rest assured that you will know a tick when you come across one. If you are checking yourself, alone, and you ever feel something suspicious that you can’t get a good look at, find someone — anyone — and have them look at it or feel it and/or describe it. You may feel a bit embarrassed, but some awkwardness with a friend, roommate, or neighbor is worth preventing a tick-borne disease!

Sometimes I find it hard to motivate myself to tick check, even though — and possibly because — I know how serious it can be to have a tick attached to me. In these cases, I fall back on some of my positive reinforcement training and promise myself something enjoyable after — a square of chocolate, a movie from Netflix, a book on tape, a cuddle with the dog. Whatever makes it easier for you to begin and to be as consistent as possible — reward yourself and make it easier the next time around.

If you do find a tick, remove it just as you would from your dog. Get your tick spoon or tick key ready.

This is the tick spoon we have. I find it easiest to use if I remove the magnifying glass, as that just tends to get in the way.

I have used the tick spoon many times. I also have a tick key, but haven’t used it yet. It wasn’t handy last night when I found the tick on my shoulder, but I know where it is now, and I’ll try it on the next one I find.

The tick key. I haven't used mine yet, but from the video I saw at the link above, I think it is well-designed.

Before you do anything, take a few deep breaths to calm yourself. You want to act with care and deliberation.

Slide the tick key or spoon between the tick’s body and your skin, until the narrowest slit of the implement is wedged against where the tick’s mouth parts are attached. Slowly and deliberately pull back and up. You will feel a bit of a tug on your skin, as if you were pulling a burr off of your skin. When the tick comes from, hopefully you will see a tiny bit of skin in its mouth parts, which means you got it all and likely didn’t squish its stomach contents under your skin by pulling or squeezing its body. (Try to avoid that.) If it’s kicking and moving around, that is also a sign that you pulled it out whole and unmangled; you actually don’t want to scare or annoy or stress the tick, as that makes it more likely to regurgitate possibly pathogenic microbes into you due to its panic.

After you have removed the tick, it’s a good idea seal it in a zip-loc baggy. This way, if you decide to have it tested to see if it was carrying diseases, it will be in the best condition for scientists to examine. I usually double- or triple-bag the tick, because I don’t want to run the risk it could escape.

Wipe the area where the tick was attached with a disinfectant, such as rubbing alcohol, hydrogen peroxide, or another cleanser. I also use a skin marker to make a circle around the site. That way, if a rash or any other skin abnormalities appear, I will know if they’re at the site of the bite or not.

If the tick is completely flat and you are sure it was only attached a very brief time, chances are good it has not passed on any diseases. However, if it is at all engorged and/or if you’re uncertain how long it was attached, it’s a good idea to speak to or see a doctor right away. An immediate course of a week of doxycycline (an antibiotic), has been shown to reduce the rates of Lyme in people who are bitten by deer ticks.

Wishing you all a safe, healthy, tick-free autumn!

– Sharon, the must of Gadget, and Barnum, SDiT